Herpes is not the end of life

DEAR DR. DONOHUE: I am a 32-year-old woman who just learned that she has genital herpes. As I understand it, this means I should not have sex and cannot have children. I also understand that there is no treatment and that I’ll have it for life. Can you paint a brighter picture for me? — K.M.

ANSWER: Someone has misinformed you. Genital herpes doesn’t pose the calamitous consequences of which you’ve been told. In the United States, 26 percent of women and 18 percent of males are infected with the herpes simplex virus-2 — HSV-2, the major cause of genital herpes. The virus does live in the body in nerve cells and, from time to time, it can emerge from its nerve-cell home and cause a visible outbreak on the genitalia. Recurrent outbreaks are milder than the first one. No one tells a herpes patient she cannot have children and cannot have a sexual relationship. Infected women who become pregnant are checked to see if they are shedding virus at the time of delivery. If they are, a cesarean section is performed. If they are not, the baby is delivered vaginally. The herpes virus is transmitted when there is an open outbreak, and people should not have sexual relations at that time. However, even when an infected person shows no signs of an active infection, the virus can still be passed. Condoms, while not 100 percent protective, cut the risk of transmission. The initial herpes infection is the worst. Tiny blisters on a red base break out on the genitals, and they progress to sores and then scabs. People might have a fever and feel ill. Healing takes place without treatment in 16 to 19 days, and more quickly when treatment is begun early. Subsequent outbreaks are less onerous. Medicines exist for herpes. They don’t eradicate the virus, but they cut short the time of observable infection. They also can be used by people who have frequent outbreaks to suppress those outbreaks. Acyclovir, famciclovir and valacyclovir are their names. The herpes booklet explains this infection in detail. To obtain a copy, write: Dr. Donohue — No. 1202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My 22-year-old son still has acne, which he has had since he was a teenager. When do those acne-causing hormones settle down? I’m anxious to see his handsome face clear up. — M.S.

ANSWER: Acne most often starts around puberty, when the surge of male hormones causes an increased production of oil, which, in turn, feeds the bacterium Propionobacterium acnes. The combination of the two clogs skin pores. They irritate the pore and give rise to a pimple. Many people are over acne by their early 20s. However, 54 percent of women and 40 percent of men between the ages of 24 and 44 still struggle with acne, and some must contend with it at even older ages. Over-the-counter medicines with benzoyl peroxide often can keep it under control. If not, people have to step up to prescription medicines, like Differin, Tazorac and Retin-A, all of which are applied to the skin. Antibiotic creams, gels or solutions often are needed, and sometimes oral antibiotics have to be used. If your son is bothered by his acne, he really ought to be under the care of a dermatologist.

DEAR DR. DONOHUE: How does a doctor tell identical twins from nonidentical ones? — E.T.

ANSWER: Identical twins come from the same fertilized egg. If twins aren’t of the same sex, obviously they aren’t identical. A large discrepancy in birth weights can indicate that twins are not identical. A single placenta is a clue that twins are identical, but it’s not an infallible clue. The placenta of identical twins has a different composition than that of fraternal (nonidentical) twins. Blood typing is another diagnostic test, and so are genetic analysis and tissue typing.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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